Toni Preckwinkle, a challenger in the race for president of the Cook County Board of Commissioners, sees an unambiguous lethargy in current county government, led by Todd Stroger.

“There’s an unwillingness or an inability to tackle the tough issues the county faces. It’s been widely thought for a long time as kind of a patronage sinkhole,” she said. “Government has an obligation to provide good services and to do that effectively and efficiently. The county is falling down on both sides of the equation.”

The alderman of the 4th Ward for the past 18 years, Preckwinkle decided she would run for the seat in December 2008 and started meeting with city council colleagues, labor unions and county committeemen shortly thereafter.

She is pitching herself as an independent leader with a command of the specifics of government in what is expected to be one of the hardest-fought local races this year. Other declared candidates include U.S. Rep. Danny Davis, Cook County Clerk Dorothy Brown and Terrence O’Brien, president of the Metropolitan Water Reclamation District board.

“I’m a reform candidate and I think I’m the only candidate who can make that claim, given my experience in city council and my willingness to stand up on tough issues like affordable housing and living wages,” she said.

While Stroger’s tenure as executive of the county has been marked by accusations of scandal and mismanagement, his full-throated support of a 1 percent increase in the county share of the sales tax has generated the most heat.

Preckwinkle called the board’s failure to override Stroger’s recent veto of a repeal of the tax “discouraging.”

She would support a gradual rollback of the tax hike with concurrent reductions in expenses in the county budget, pointing to the highway department as one part of county government that could be reduced.

And the budget could be boosted on the revenue side as well, according to Preckwinkle. The county must become more aggressive in getting federal dollars that exist to support services it will deliver anyway, Preckwinkle said, especially in health care.

“They didn’t collect, between 2005 and 2007, $139 million in Medicare and Medicaid funding they were entitled to because they couldn’t manage to get the billing systems working,” she said.

Preckwinkle would also make the independent board overseeing county health care a permanent body. It now operates on a three-year timetable.

With health care, criminal justice and economic development, Preckwinkle said she would reach out to other institutions and elected officials working on those respective issues.

The county health care system, provider of last resort for the poor and others with no insurance, should, she said, collaborate closely with hospitals like Mercy, which serves people dependent on Medicare and Medicaid, and primary care health clinics.

Similarly, she would convene the sheriff, state’s attorney and chief judge to identify how to lower the county jail population. And Preckwinkle wants to integrate the county into regional economic development plans.

Budgeting at county, meanwhile, needs a fresh approach as well – Preckwinkle said a friend who formerly worked in the city budget department told her the best course for the county budget was starting over “with a blank sheet of paper.”

“It’s hard to figure out what the real numbers are, and there hasn’t been a tradition in the county of making information available to people,” she said.

Preckwinkle was born in St. Paul, Minn., and moved to the city to earn a master’s degree from the University of Chicago. She taught history for 10 years, served in Mayor Harold Washington’s administration and led a nonprofit called the Chicago Jobs Council before winning her current seat in 1991 by a margin of 109 votes out about 11,000 cast.

In her current race, Preckwinkle’s seeking out endorsements from a wide range of officials – everyone from Mayor Richard Daley and unions to other alderman and officials from suburban districts.

A recent Sunday included stops at a picnic sponsored by the Democratic Party of Evanston, the 49th Ward in Chicago, Greektown and a block party in her ward. She is aiming for support from many constituencies.

“I hope to have a base of support in the African-American community beyond my ward, to work very hard to gain support from the Latino community since there isn’t a Latino candidate in the race,” she said, “to appeal to women across the county and to independent, progressive Democrats.”